Provider Demographics
NPI:1861621534
Name:DETROIT MEDICAL CENTER
Entity type:Organization
Organization Name:DETROIT MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDRAM NAIDU
Authorized Official - Middle Name:
Authorized Official - Last Name:MUPPURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-663-0023
Mailing Address - Street 1:3990 JOHN R ST
Mailing Address - Street 2:BOX162
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2018
Mailing Address - Country:US
Mailing Address - Phone:313-745-7233
Mailing Address - Fax:
Practice Address - Street 1:3990 JOHN R ST
Practice Address - Street 2:BOX162
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2018
Practice Address - Country:US
Practice Address - Phone:313-745-7233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No282NW0100XHospitalsGeneral Acute Care HospitalWomen